Article Reviews: Post Traumatic Stress Disorder

Article Reviews: Post Traumatic Stress Disorder (PTSD)

Article 1

The first article is by Hageman, Anderson, and Jorgensen, who review how different pharmacological and psychobiological interventions are adequate for PTSD expressions. In this case, a substantive review of the literature searches concluded that PTSD affected the pathways of opioid, GABAergic, glutamatergic, neuroendocrine, and serotonergic when evaluating the psychophysiology pathways of PTSD (Hageman et al. 411). Different medications work for different symptoms of the diseases, including using selective serotonin reuptake inhibitors, tricyclic antidepressants (TCAs), both the reversible and irreversible MAO-inhibitors, and the anticonvulsant lamotrigine (Hageman et al. 412). Based on these findings, the authors make various suggestions, especially on the levels of the pharmacotherapy based on the type of symptoms and severity of the PTSD conditions, including comparing if the individual was involved in combat or not. In this case, the authors recommend that antidepressants that are classified as the selective serotonin reuptake inhibitors (SSRIs) are the first line of treatment in the core PTSD symptoms because of the efficacy in the three major symptom clusters of the disease than any of the drugs for numbing and avoidance clusters (Hageman et al. 419). The second line includes the TCAs, which are effective, especially in treating and ameliorating the anxiety and depressive symptoms that are intrusive for PTSD patients (Hageman et al. 419). These also have little effect on the numbing and avoidance symptoms. The MAO-inhibitors are considered the third line of treatment choice due to the additional elements of TCAs, including helping patients that take alcohol to reduce the alcohol and potential adverse effects associated with drug abuse (Hageman et al. 419).

These authors mostly use the literature review approach to reach their conclusions based on interrogating how various medications respond to various expressions of the PTSD symptoms. The analysis is based on the dysregulation of some of the psychological pathways affected by PTSD and how various pharmacology interventions focusing on various types of medicines respond to the symptoms arising from particular pathways to recommend the most effective drugs. However, PTSD involves the psychological and neurological responses and the mind. In this case, the authors could have also considered the impact of non-pharmacological interventions, including psychotherapists and clinical counseling, over time that help the victims overcome or learn to manage the stressors. Therefore, more research questions could arise in comparing the effectiveness of the pharmacotherapies compared to the non-pharmacological interventions.

Article 2

The second article is by Richard Bryant, which focuses on the review of PTSD condition and how various definitions have led to differences in the type of response to the patients with the condition. First, Bryant recognizes that most patients with the PTSD condition express the symptoms because of exposure to a traumatic event which is a stress trigger to the condition (259). In this case, Bryant indicates that there are two main approaches to defining the condition of PTSD based on the DSM-5 and ICD-11 disagreement (260). On one end, PTSD is defined as including the construct of the diseases resulting from the psychological manifestation a patient experiences after exposure to the traumatic experiences. However, other definitions are centered on the idea that the construct of PTSD is based on the memory phenomena of the brain and neurological pathways affected that arise after trauma. Bryant claims that the impact of these differences limits the effective identification of appropriate biomarkers of the diseases and the specific mechanisms that lead to the development of traumatic stress (263). Therefore, the author review literature on the evidence-based interventions and concludes that only two-thirds of the patients have responded well to the cognitive behavioral therapy that is most preferred for PTSD patients (Bryant 265). Therefore, seeking a combination of cognitive-behavioral therapy and pharmacological therapy can enhance the disease’s practical outcomes and help overcome some barriers, such as the lack of access to such evidence-based treatment in low and middle-income countries (Bryant 269).

The authors mostly interrogate literature to explore various foundations for interventions for PTSD disease. This includes exploring the effectiveness of the cognitive-behavioral approach compared to pharmacological interventions through drugs targeting the memory. However, the author advances the need to consider recent evidence-based treatments such as a combination of the two and focus on specific symptoms of the patient for effective outcomes. There could be more research on how the two combinations work together and what interventions are best for particular symptoms. This is because the nature of the traumatic experience and the symptoms that patients show differ.

Article 3

The last article is by Robert Fenster and other authors that focus on the most recent developments in understanding the impact of PTSD on brain dysfunction and alternative treatments that have been effective in the recent past. In this case, the authors claim that PTSD is becoming a prevalent disease for many people and sometimes could be severe to the extent of causing severe psychological trauma to an individual (Fenster et al. 535). Most of the focus in the recent past has been on treatments using antidepressants, and cognitive behavioral therapy, which the authors claim are limited (Fenster et al. 535). Based on this assumption, the authors then indicated that new approaches enhance the prevention and treatment of PTSD symptoms based on recent evidence-based research on the underlying PTSD dysfunctional brain circuits (Fenster et al. 535). This research, aided by recent advanced technologies, has enabled researchers to map out the macrocircuits and microcircuits related to particular PTSD symptoms; hence, developing treatments focusing on such pathways could better manage risk and enhance resilience as a new therapeutic discovery.

Considering these are new advancements, there still needs to be intensive research, especially building on the previous interventions for PTSD, including the cognitive and behavioral therapies and how specific medication responds to particular symptoms. The main aim is to enhance how recent developments and past interventions can effectively improve patient health outcomes and manage stressors. 

Works Cited

Bryant, Richard A. “Post‐Traumatic Stress Disorder: A State‐Of‐The‐Art Review Of Evidence And Challenges.” World Psychiatry, vol 18, no. 3, 2019, pp. 259-269. Wiley, https://doi.org/10.1002/wps.20656. Accessed 26 May 2022.

Fenster, Robert J. et al. “Brain Circuit Dysfunction In Post-Traumatic Stress Disorder: From Mouse To Man.” Nature Reviews Neuroscience, vol 19, no. 9, 2018, pp. 535-551. Springer Science And Business Media LLC, https://doi.org/10.1038/s41583-018-0039-7. Accessed 26 May 2022.

Hageman, I. et al. “Post-Traumatic Stress Disorder: A Review Of Psychobiology And Pharmacotherapy.” Acta Psychiatrica Scandinavica, vol 104, no. 6, 2001, pp. 411-422. Wiley, https://doi.org/10.1034/j.1600-0447.2001.00237.x.